Lupe Del Angel holds a sign outside of the Southwestern Women’s Surgery Center in Dallas on Friday. A third of the abortion clinics in Texas can no longer perform the procedure starting Friday after a federal appeals court allowed most of the state’s new abortion restrictions to take effect.

HARLINGEN, Texas — In a Texas abortion clinic, about a dozen women waited Friday to see the doctor, already aware that they would not be able to end their pregnancies there.

A day after a federal appeals court allowed most of the state’s new abortion restrictions to take effect during a legal challenge, about a third of Texas’ clinics were barred from performing the procedure.

Thursday’s ruling made Texas the fourth and largest state to enforce a provision requiring doctors who perform abortions to have admitting privileges in a nearby hospital. In places such as the Rio Grande Valley and rural West Texas, the mandate put hundreds of miles between many women and abortion providers.

Anti-abortion groups welcomed the court’s surprise decision, which they insisted would protect women’s health. The ruling came just a few days after a lower federal court put the law on hold.

A panel of judges at the 5th Circuit Court of Appeals in New Orleans ruled that Texas can enforce the law while a lawsuit challenging the restrictions moves forward.

The law that the Legislature passed in July also bans abortions at 20 weeks and, beginning in September 2014, requires doctors to perform all abortions in surgical facilities.

But it’s the provision about admitting privileges that has idled Dr. Lester Minto’s hands here in Harlingen, near the Texas-Mexico border.

After the law was adopted, the clinic began preparing to close, shredding old patient records and drawing down their inventory, ordering only enough supplies to keep going for a month at a time.

Minto, who has been performing abortions for 30 years, predicted the women he sees would take dangerous measures in their desperation. He made clear he would not perform abortions Saturday if they remain prohibited, but he did not rule out taking other steps in the future.

“I’m going to continue helping girls somehow,” he said.

Without access to his services, “they’ll do drastic things,” Minto predicted. “Some, they may even commit suicide.”

He said he has seen women take various concoctions hoping to end pregnancies. Others have been beaten by boyfriends who pounded their abdomens with bats.

The communities Minto serves are among the nation’s poorest. On top of that, many of his patients cross the border from Mexico, where abortion is illegal in most places. Others live in the U.S. illegally.

If this clinic and one in nearby McAllen are forced to close, women seeking abortions would be faced with taking days off work, finding childcare and paying for hotels in cities such as San Antonio, Austin or Houston.

The Supreme Court prohibits legislatures from banning most abortions, acknowledged Joe Pojman, executive director of Texas Alliance for Life. But, he said in a statement, “states should have the right to protect women from dangerous abortion procedures.”

Texas follows Utah, Tennessee and Kansas in enforcing the admitting privileges law. Similar laws are under temporary court injunctions in Alabama, Wisconsin, North Dakota and Mississippi, which also falls under the 5th Circuit Court of Appeals. The appeals court has left in place the temporary injunction against the Mississippi law.

The Supreme Court has ruled in past decisions that lawmakers may not pass laws that would effectively end abortions in a state because that would put an undue burden on women trying to exercise their right to end a pregnancy.

In Thursday’s opinion, appellate Judge Priscilla Owen noted that the Texas law would not end the procedure, only force women to drive a greater distance to obtain one.